Individual
LESLEY-ANNE PHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2040 COLISEUM DR # A27, HAMPTON, VA 23666-3200
(757) 262-0020
Mailing address
350 N CLARK ST STE 600, CHICAGO, IL 60654-4782
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416259
VA
Other
Enumeration date
08/13/2018
Last updated
01/31/2019
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